Provider Demographics
NPI:1093908766
Name:SALAZAR, JANIE ANN (APRN, FNP, MSN, PHN)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:ANN
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:APRN, FNP, MSN, PHN
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ANN
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:9300 VALLEY CHILDRENS PL
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-6022
Mailing Address - Fax:559-353-7176
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:MOB-CHILD ADVOCACY CLINIC SUITE 105
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6022
Practice Address - Fax:559-353-7176
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-967261QM1102X, 363LF0000X
CA376865261QM2500X
CA15456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QM1102XAmbulatory Health Care FacilitiesClinic/CenterMilitary Outpatient Operational (Transportable) Component
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty